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Vol. 46. Issue S10.
Nuevos enfoques en el tratamiento de la EPOC
Pages 25-32 (December 2010)
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Vol. 46. Issue S10.
Nuevos enfoques en el tratamiento de la EPOC
Pages 25-32 (December 2010)
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Perfil clínico del roflumilast
Clinical profile of roflumilast
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José Luis Izquierdo Alonso
Servicio de Neumología, Hospital Universitario, Guadalajara, España
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Los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) y bronquitis crónica asociada poseen un mayor riesgo de presentar exacerbaciones. Las exacerbaciones son una causa importante de morbilidad y deterioro de su calidad de vida; además, se asocian con una progresión acelerada de la enfermedad y con una mayor mortalidad. Los síntomas típicos de la bronquitis crónica (tos crónica y producción de esputo) se correlacionan con marcadores de la inflamación que existe en la EPOC.

El roflumilast es un fármaco antiinflamatorio perteneciente a la nueva clase terapéutica de los inhibidores de la fosfodiesterasa-4. Es el primer fármaco desarrollado para el tratamiento de un fenotipo específico de la EPOC (EPOC asociada a bronquitis crónica). Los resultados de los ensayos clínicos indican que, en pacientes con EPOC asociada a bronquitis crónica e historia de exacerbaciones, el roflumilast mejora la función pulmonar y reduce los síntomas y la frecuencia de exacerbaciones que requieren intervención médica. Este efecto se mantiene cuando se añade a un tratamiento regular con un broncodilatador de larga acción o a un corticoide inhalado.

Palabras clave:
EPOC
Bronquitis crónica
Roflumilast
Abstract

Patients with chronic obstructive pulmonary disease (COPD) and associated bronchitis are at higher risk of exacerbations, which are a major cause of morbidity and impaired quality of life. Moreover, exacerbations are associated with more rapid disease progression and higher mortality. The typical symptoms of chronic bronchitis (chronic cough and sputum production) are correlated with inflammatory markers in COPD.

Roflumilast is an anti-inflammatory drug belonging to the novel therapeutic class of phosphodiesterase-4 inhibitors and is the first drug to be developed for the treatment of a specific COPD phenotype (COPD associated with chronic bronchitis). The results of clinical trials indicate that, in patients with COPD associated with chronic bronchitis and a history of exacerbations, roflumilast improves pulmonary function and reduces the symptoms and frequency of exacerbations requiring medical intervention. This effect is maintained when regular treatment with a long-acting bronchodilator or an inhaled corticosteroid is added.

Keywords:
COPD
Chronic bronchitis
Roflumilast
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